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Urinary Prolapse - Altius Hospital

December 9, 2019 by AltiusHospital  

What is a prolapse uterus?

 

The uterus, or womb, is a muscular structure that's held in place by pelvic muscles and ligaments. If these muscles or ligaments stretch or become weak, they're no longer able to support the uterus, causing prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position and into the vagina, or birth canal.

 

Uterine prolapse may be incomplete or complete. An incomplete prolapse occurs when the uterus is only partly sagging into the vagina. A complete prolapse describes a situation in which the uterus falls so far down that some tissue rests outside of the vagina.

 

 

WHAT ARE THE POSSIBLE Risk factors for uterine prolapse?

 

The risk of having a prolapsed uterus increases as a woman ages and her estrogen levels decrease. Estrogen is the hormone that helps keep the pelvic muscles strong. Damages to pelvic muscles and tissues during pregnancy and childbirth may also lead to prolapse. Women who've had more than one vaginal birth and postmenopausal women are at the highest risk.

 

Any activity that puts pressure on the pelvic muscles can increase your risk of a uterine prolapse. Other factors that can increase your risk for the condition include:

 

Confirmed risk factors

 
  • Increasing age
  • Vaginal delivery
  • Increasing parity
  • Obesity
  • Previous hysterectomy

Possible risk factors :

 
  • Obstetric factors:
 
  1. Prolonged second stage of labour.
  2. Increased birth weight.
  3. Pregnancy itself (as opposed to delivery factors).
  4. Use of forceps.
  5. Age < 25 years at first delivery.
  6. Shape of pelvis.
 
  • Family history of prolapse.
  • Constipation.
  • Connective tissue disorders
  • Occupations involving heavy lifting.

What are the Vaginal/general symptoms?

 
  • Sensation of pressure, fullness or heaviness.
  • Sensation of a bulge/protrusion or 'something coming down'.
  • Seeing or feeling a bulge/protrusion.
  • Difficulty retaining tampons.
  • Spotting (in the presence of ulceration of the prolapse).

What are the Urinary symptoms?

 
  • Incontinence.
  • Frequency.
  • Urgency.
  • Feeling of incomplete bladder emptying.
  • Weak or prolonged urinary stream.
  • The need to reduce the prolapse manually before voiding.
  • The need to change position to start or complete voiding.

Is there any Coital difficulty in prolapse?

 
  • Dyspareunia.
  • Loss of vaginal sensation.
  • Vaginal flatus.
  • Loss of arousal.
  • Change in body image.

HOW IS IT GRADED?

 

Uterine prolapse is graded based on level of descent:

 
  • 1st degree: To the upper vagina
  • 2nd degree: To the introitus
  • 3rd degree: Cervix is outside the introitus
  • 4th degree (sometimes referred to as procidentia): Uterus and cervix entirely outside the introitus

Vaginal prolapse may be 2nd or 3rd degree.

 

What are the Types of prolapse?

 

Prolapse can occur in the anterior, middle, or posterior compartment of the pelvis.

 

What is Anterior compartment prolapsed?

 
  • Urethrocele: prolapse of the urethra into the vagina. Frequently associated with urinary stress incontinence; other symptoms are infrequent.
  • Cystocele: prolapse of the bladder into the vaginaa large cystocele may cause increased urinary frequency, frequent urinary infections and a pressure sensation or mass at the introitus.
  • Cystourethrocele: prolapse of both urethra and bladder.

WHAT ARE THE BLADDER TRAINING EXERCISES?

 

Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every two to four hours.

 

Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.

 

Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.

 

Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.

 

What is Middle compartment prolapse?

 

Uterine prolapse: descent of the uterus into the vagina.

 
  • Vaginal vault prolapse: descent of the vaginal vault post-hysterectomy. Often associated with cystocele, rectocele and enterocele.
  • Enterocele: herniation of the pouch of Douglas (including small intestine/omentum) into the vagina.

WHAT IS VAGINAL PROLAPSE?

 

Uterine prolapse is descent of the uterus toward or past the introitus. Vaginal prolapse is descent of the vagina or vaginal cuff after hysterectomy

 

How is uterine prolapse diagnosed?

 

Your doctor can diagnose uterine prolapse by evaluating your symptoms and performing a pelvic exam.

 

Any Conservative methods to treat prolapse?

 

These measures are particularly helpful for women who:

 
  • Have mild prolapse.
  • Want to have further pregnancies.
  • Are frail or elderly.
  • Have a high anaesthetic risk.
  • Do not wish to have surgery.

What are the Conservative measures available?



Watchful waiting. If a women reports little in the way of symptoms this is probably appropriate. Treatment may be needed if symptoms become troublesome or if complications develop.

 

Lifestyle modification: including treatment of cough, smoking cessation, constipation and overweight and obesity. However, even though the association of prolapse with these lifestyle factors has been demonstrated, the role of lifestyle modification as a prevention or treatment of prolapse is not supported by evidence.

 

Pelvic floor muscle exercises.

 

Vaginal oestrogen creams.

 

Oestrogen creams before surgery may reduce the incidence of postoperative cystitis

 

When to consider Surgery?

 
  • Failure of conservative treatment.
  • Presence of voiding problems or obstructed defecation.
  • Recurrence of prolapse after surgery.
  • Ulceration.
  • Irreducible prolapse.
  • The woman prefers surgical treatment.

WHAT ARE THE SURGICAL OPTIONS?

 
  1. Surgical treatments include uterine hysterectomy( hysterectomy with surgical repair of the pelvic support structures (colporrhaphy) OR
  2. suspension ( (suturing of the upper vagina to a stable structure nearby).
  3. Surgical options include a vaginal approach (for sacrospinous ligament suspension or sacrospinous colpopexy) and an abdominal/laparoscopic approach (sacrocolpopexy).

Laparoscopic repair of prolapse has less risk of perioperative morbidity than laparotomy.

 

Using mesh may lower the risk of prolapse recurrence after a vaginal repair, but complications may occur more frequently. Patients should be advised that all mesh may not be removed completely so that they can make an informed decision.

 

How can I prevent uterine prolapse?

 
  1. Uterine prolapse may not be preventable in every situation. However, you can do to things to reduce your risk, including:
  2. Good intrapartum care, including avoiding unnecessary instrumental trauma and prolonged labour.
 
  • Hormone replacement therapy, although its role in preventing prolapse is uncertain.
  • Pelvic floor exercises may prevent prolapse occurring secondary to pelvic floor laxity and are strongly advised before and after childbirth.
  • Smoking cessation will reduce chronic cough (and therefore intra-abdominal pressure).
  • Weight loss if overweight or obese.
  • Treatment of constipation throughout life.
  • getting regular physical exercise
  • practicing Kegel exercises

What is kegels exercise?

 

Kegel exercises, also called pelvic floor exercises, help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles, you can reduce or prevent leakage problems.

 

How is it done?

 

Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.Do it 3-4 times a day.

 
  • Is laparoscopy better option?

Laparoscopic sacrocervicopexy is an effective option for women with pelvic organ prolapse who desire uterine preservation. Laparoscopic surgery gives the added benefit of shorter hospital stay,better cosmesis,lesser postoperative pain,short recovery period .

 
  • Will the sexual functions be hampered after this surgery?

not necessarily.

 
  • what will be the time period to go back to work ?

2-3 days.

 
  • dietary restrictions if any?

to have a balanced diet

 
  • any form of exercises to be followed post-op?

Any form of physical activity say yoga,meditation,walking ,sport to keep urself fit n fine.

 

Will there be weight gain later?

 

No surgery does not make you put on weight.might be the restriction of physical inactivity self imposed can lead to weight gain.

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

Fax: +91 8023116750

Email: altiushospital@yahoo.com | endoram2006@yahoo.in 

 

Follow the links:

 

Gynecologist in Bangalore | IVF Treatment Center in Bangalore | Uterus Removal Surgery in Bangalore

Egg Donation - Altius Hospital

December 5, 2019 by AltiusHospital  

Egg donation is one of the techniques of reproductive medicine.Its basic principle consists of retrieving from a woman (called a donor) her reproductive cells or eggs, called oocytes or ova, which are situated in the ovary, in order to donate them to another woman (the patient, called the recipient) to be used in the latter’s parenting project, through in vitro fertilization (IVF) (Fig.1). This donation, regarded by some for as a donation of an organ or blood, is a donation of life, result of the fruit of great feminine solidarity, enabling certain women to allow others to become mothers. This exceptional donation without any doubt gives rise to questions at various levels: practical, genetic and ethical.

 

 

WHO IS A CANDIDATE FOR DONOR EGGS?

 

The Donor Egg Program is designed for patients who cannot conceive from their own eggs. Most commonly, such patients include.

  • Early menopause or ovarian dysgenesis
  • Genetic disease
  • Ovarian insufficiency
  • Insufficient egg quality during IVF
  • Late age for reproduction (physiological men pause)

DOES THE EGG RECIPIENT KNOW THE EGG DONOR?

 

Most commonly not. Most of the patients choose an anonymous donor, someone who is unknown to them. Patients find a suitable egg donor, either from donor pool or from an agency that provides such donors. The identity of the egg donor will never be disclosed to the recipient. Anonymous donors get compensated financially for their time and efforts by the recipient. Some patients may have relatives or friends who are ready to donate eggs for them.

 

HOW ARE DONORS SCREENED?

 

Anonymous donors have to be 21-32 years old, physically and psychologically healthy and non-smokers. Candidates fill out a questionnaire, which includes detailed medical history, genetic history, family history, as well as social behavior and general interests. Psychological, emotional, ethical and legal aspects of the donation are discussed. It is of extreme importance to us to make sure that the donor is fully informed and comfortable with the process, and that the donation process will not affect her adversely. Once the donor gives her full, voluntary consent to participate in the process, the following tests then take place:

 
  • Medical history and physical examination
  • Testing for infectious diseases like VDRL, Hepatitis, AIDS, etc.
  • Genetic testing
  • Psychological testing including an interview with the program’s psychologist

DO RECIPIENTS GET SCREENED AS WELL?

 

Yes. Patients will have an initial consultation . At that time all aspects of the egg donation will be discussed. Special issues that will be addressed include the anonymity of the donor, the screening of the donor, and the potential psychological impact that having a child through egg donation might have on the recipient. Since we realize that the decision to conceive through egg donation may be very difficult for the couple, they will be referred for a psychological intake and emotional support to discuss issues such as third-party reproduction, issues of disclosure to the future offspring and parenting at a later age, where appropriate. Patients 45 years or older will need medical clearance from their internist, in addition to pre-conception counseling with a high-risk obstetrician. Both the recipient and her male partner will be screened for infectious diseases. The partner will provide a sperm sample for evaluation and freezing. Arrangements can be made for donor sperm in applicable cases.

 

HOW DOES THE ACTUAL DONOR CYCLE WORK

 

Recipient and donor cycles are synchronized with the help of medications. The donor receives fertility injections for 7-13 days to stimulate her ovaries to produce eggs. During that time period, she gets monitored frequently by blood tests and ultrasounds. In the meantime, the recipient’s uterine lining is prepared with estrogen. Once the donor’s eggs seem ready, she receives an HCG injection. One-and-a-half days later, she undergoes an egg retrieval procedure. This procedure is done with the guidance of a vaginal ultrasound machine and under anesthesia (IV sedation). The donor is discharged following observation in the recovery room.

 

DONOR IS ADVISED TO PRACTICE CONTRACEPTION FOR ANOTHER 3 WK AS THERE MIGHT BE A CHANCE FOR DONOR TO CONCEIVE.

 

All eggs are isolated, counted and placed safely in the incubator. The recipient starts progesterone treatment. Her husband provides a sperm specimen. The donor’s eggs are then fertilized with the recipient husband’s sperm, and returned to the incubator. Embryo development is recorded in the lab over several days. Finally, on the third or fifth day post retrieval, several embryos are transferred into the recipient’s uterus. The remaining embryos are frozen for future use by the recipient couple.

 

Planning the Cycle:

 

An Egg Donor IVF cycle consist of the following protocol:

 
  1. Selection and screening of Egg Donor.
  2. Synchronized Donor stimulation and Intended mother’s endometrial preparation ( a.Donor Stimulation, Follicular monitoring of Egg donor and b.Endometrium Preparation of Intended mother. )
  3. Egg Pick Up & IVF or Cryopreservation of eggs/ embryos.
  4. Embryo Transfer to Intended Mother or freezing of embryos. Hormone Assays.

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

Fax: +91 8023116750

Email: altiushospital@yahoo.com | endoram2006@yahoo.in

 

Follow the links:

 

Gynecologist in Bangalore | IVF Treatment Center in Bangalore | Uterus Removal Surgery in Bangalore

Family Planning Methods - Altius Hospital

November 29, 2019 by AltiusHospital  

Contraception (anti-conception medication) avoids pregnancy by meddling with the ordinary procedure of ovulation, treatment, and implantation. There are various types of anti-conception medication that demonstration at various focuses in the process. NO SINGLE METHOD IS APPLICABLE TO ALL.



What are Contraceptive inserts and infusions? 

 

Hormonal contraception for ladies is accessible as inserts and infusions. These strategies, especially the embed, are more viable than prophylactic pills and rings, yet like other preventative techniques, may cause symptoms and don't give assurance from Sexually transmitted diseases. 

 

Inserts 

 

The prophylactic embed . is a hormonal, pole molded gadget that is embedded under the skin at the internal side of the upper arm. .it has a hormone that stops ovulation and makes the liquid at the opening to the uterus (belly) thicker, preventing sperm from overcoming. 

 

The prophylactic embed goes on for a long time, is near 100 percent successful and suits most ladies who can't take manufactured oestrogens. The embed is placed in by a specialist under nearby soporific. 

 

Infusions (Depo) 

 

The preventative infusion . is a hormonal injection.this technique stops ovulation and makes the liquid at the opening to the uterus thicker, preventing sperm from traversing. The prophylactic infusion is an exceptionally compelling . .Infusion IS GIVEN AT the interim of 2 or 3 months. 

 

Give me a data about Contraceptive intrauterine gadgets (IUDs)? 

 
  1. The IUD is a little plastic gadget with included copper or hormones that is placed into the uterus by a specialist. It can remain set up for as long as 10 years, contingent upon the sort utilized. Ladies who need to get pregnant or are having issues can undoubtedly have the IUD taken out before. 
  2. The two kinds of IUD (copper and hormonal) are more than 99 percent compelling and work by changing the coating and condition of the uterus so sperm can't endure. On the off chance that any sperm do endure and treat an egg, the egg can't adhere to the mass of the uterus, which implies a pregnancy can't occur. 
  3. The hormonal IUD (Mirena0) makes periods lighter or stop out and out. It might should be taken out due to hormonal side effects, for example, cerebral pains, bosom delicacy, skin inflammation and expanded craving, yet this is uncommon. The copper IUD will in general make periods heavier, yet doesn't cause hormonal reactions. 
  4. The hormonal IUD gradually and consistently discharges a modest quantity of hormones, which may make the liquid at the opening to the uterus thicker, preventing sperm from traversing. This may likewise forestall pregnancy by somewhat change the hormones that control the menstrual cycle.

What is Emergency contraception? 

 

Crisis contraception, otherwise called 'a next day contraceptive', is a hormonal strategy for contraception that may stop ovulation. It tends to be taken to abstain from getting pregnant in a crisis circumstance, for example, in the wake of having unprotected sex, if a condom sneaks off or breaks during sex, or if the preventative pill is missed. It forestalls 85 percent of. pregnancies that would somehow or another have occurred.

 

 

Shouldn't something be said about Contraceptive pills and vaginal rings? 

 

Hormonal contraception for ladies is likewise accessible with a specialist's remedy as a pill (oral contraception) or a vaginal ring .. These techniques are extremely successful (99.7 percent) .Pills and vaginal rings may cause symptoms and don't give insurance from STIs. 

 

Joined pill 

 
  • The joined pill contains engineered types of the hormones estrogen and progesterone. It stops ovulation and makes the liquid at the opening to the uterus thicker, preventing sperm from traversing. 
  • There are numerous sorts of joined pills with various dosages and hormones. This strategy is by and large not prescribed for ladies who are in danger of coronary illness, for example, smokers who are more than 35 years old. 

Small scale pill 

 

The small scale pill contains a manufactured type of just a single hormone, progesterone. It makes the liquid at the opening to the uterus thicker, preventing sperm from traversing. 

 

Vaginal ring 

 
  • The vaginal ring has comparable hormones to the joined pill and works similarly. 
  • The vaginal ring discharges a low portion of hormones and spares making sure to take a pill consistently. It is additionally as simple to place in as a tampon and, similar to the joined pill, is 99.7 percent viable whenever utilized the correct way. 
  • Male and female condoms likewise reduce the danger of STIs. Hindrance techniques can be successful whenever utilized the correct way every time you engage in sexual relations. 

What are the Permanent techniques for contraception? 

 

Cleansing is a perpetual technique for contraception that includes having a surgery. Female and male sanitization are powerful, yet these strategies don't give insurance from STIs. 

 

What are Natural strategies for contraception? 

 
  • Regular techniques, known as normal family arranging, depend on observing body changes during the menstrual cycle to know when a lady is generally rich. These progressions are utilized as a manual for realize when to have intercourse and when to abstain from engaging in sexual relations. Strategies incorporate observing changes to the internal heat level's and the liquid at the opening to the uterus.
  • The viability of normal family arranging shifts, contingent upon which strategy or blend of techniques is utilized. Regular family arranging doesn't give insurance from STIs. Entirely eccentric and not suggested 

Does a Contraceptive offers insurance from STIs? 

 

It is essential to rehearse more secure sex, just as to avoid a unintended pregnancy. Not all techniques for contraception give insurance from STIs. The most ideal approach to reduce the danger of STIs is to utilize obstructions, for example, male and female condoms . 

 

In the event that I intend to have an infant, how not long after in the wake of halting the anti-conception medication pill would i be able to consider? 

 

Most ladies ovulate again around about fourteen days subsequent to halting the pill. When you ovulate once more, you can get pregnant. In the event that this occurs during your first cycle off the pill, you might not have a period by any means. Check a pregnancy test on the off chance that you've had unprotected intercourse and your period hasn't returned. 

 

What occurs on the off chance that I quit taking the conception prevention pill and my period doesn't return? 

 
  • On the off chance that you don't have a period for a while, you may have what's known as post-pill amenorrhea. The pill keeps your body from making hormones engaged with ovulation and feminine cycle. At the point when you quit taking the pill, it can set aside some effort for your body to come back to ordinary generation of these hormones. 
  • Your period ordinarily continues inside a quarter of a year after you quit taking the pill. Be that as it may, a few ladies, particularly the individuals who took the pill to control their menstrual cycles, might not have a period for a while. 
  • On the off chance that you don't include a period inside a quarter of a year, take a pregnancy test to ensure you're not pregnant and afterward observe your primary care physician. 

What occurs on the off chance that I take conception prevention pills while pregnant? 

 
  • Try not to stress in the event that you continued taking your anti-conception medication pill since you didn't have any acquaintance with you were pregnant. When you discover that you're pregnant, quit taking the conception prevention pill and counsel specialist.
  • I have taken contraception pills for a considerable length of time and need to stop. 

Would i be able to stop whenever or would it be advisable for me to complete my present pill bundle? 

 

At the point when you at long last stop the pill, you can anticipate some dying, which may change the cadence of your menstrual cycle. In any case, you can stop whenever. 

 

Do anti-conception medication pills cause weight gain? 

 
  • Numerous ladies think so. In any case, thinks about have demonstrated that the impact of the conception prevention pill on weight is little - on the off chance that it exists by any means. 
  • Rather, you might be holding increasingly liquid, which can make you feel as though you've put on weight, especially in your bosoms, hips and thighs. The estrogen in anti-conception medication pills affects (fat) cells, making them bigger however not increasingly various. 

How contraception pills influence malignant growth chance? 

 
  • Logical proof proposes utilizing contraception pills for longer timeframes expands your danger of certain tumors, for example, cervical malignancy and liver disease, yet the outcomes aren't reliable. 
  • On the other side, the conception prevention pill may diminish your danger of different kinds of malignant growth, including ovarian disease and endometrial malignant growth. 
  • Be that as it may, the present pills have a much lower estrogen portion, and later investigations show no expansion in bosom disease hazard on the off chance that you take anti-conception medication pills. Concentrates likewise have discovered no connection between bosom malignant growth hazard and utilization of conception prevention pills in ladies who have a family ancestry of bosom disease. 

Do contraception pills influence cholesterol levels? 

 

Contraception pills can influence your cholesterol levels. Contraception pills with more estrogen can have a marginally helpful by and large impact on your blood lipid levels. As a rule, however, the progressions aren't critical and don't influence your general wellbeing. 

 

Do contraception pills influence circulatory strain? 

 

Contraception pills may marginally expand your pulse. On the off chance that you take conception prevention pills, have your circulatory strain checked routinely. In the event that you as of now have hypertension, converse with your primary care physician about whether you ought to think about another type of contraception. 

 

Can ladies more seasoned than age 35 keep taking contraception pills? 

 

In case you're solid and you don't smoke, you can keep taking contraception pills after age 35. Nonetheless, contraception pills aren't suggested in case you're 35 or more seasoned and you smoke as a result of the danger of cardiovascular illness. All things considered, you have to stop smoking before you can securely keep utilizing anti-conception medication pills. 

 

What is lasting disinfection? 

 

Female cleansing (likewise alluded to as tubal ligation) incorporates various methods and procedures that give changeless contraception to ladies. The most widely recognized strategies forestall pregnancy by disturbing the patency of the fallopian tubes. This counteracts origination by blocking transport of sperm from the lower genital tract to an ovulated oocyte.IN guys it is vasectomy.,which squares vas deferens that conveys sperms. 

 

When to plan?



Female sterilization may be performed immediately after childbirth (postpartum sterilization) or at a time unrelated to a pregnancy (interval sterilization). Most postpartum sterilization procedures are performed at time of cesarean delivery or after a vaginal delivery .Most interval sterilization procedures are performed via laparoscopy.

 

What are the indications?

 
  • The only indication for sterilization is the patient's desire for permanent contraception. Ultimately, the choice is made by the patient, but the decision requires thorough counseling about permanent sterility and the risk of regret.
  • There are no medical conditions that are strictly incompatible with laparoscopic sterilization; however, there may be factors that make women more suitable for a particular route of sterilization or other contraceptive options.

How effective is laparoscopic sterilization in preventing pregnancy?

 

Laparoscopic sterilization is highly effective 100%

 

Why laparoscopy?

 

For women who no longer want children, sterilization by laparoscopy provides a safe and convenient form of contraception. Once completed, no further steps are needed to prevent pregnancy. Tubal ligation also does not change a woman's menstrual cycle or cause menopause.

 
  1. Its day care surgery
  2. Done under general anaesthesia.
  3. Lesser pain
  4. No scar
  5. Recovery in a day

How is laparoscopic sterilization performed?

 

In laparoscopy, an instrument called a laparoscope is inserted through a small incision made in or near the navel. Another small incision may be made for an instrument to close off or remove the fallopian tubes. The fallopian tubes can be closed off by bands or clips. They also can be cut and closed with special thread or sealed with an electric current. The laparoscope then is withdrawn. The incisions are closed with stitches or special tape.

 

What are the risks associated with laparoscopic sterilization?

 

Sterilization by laparoscopy has a low risk of complications. Its vey safe.

 

What should I expect after having laparoscopic sterilization?

 

After surgery, you will be observed for a short time to be sure that there are no problems. Most women can go home 2-4 hours after the procedure.. You may feel some discomfort or have other symptoms that last a few days

 

What are some alternatives to sterilization?

 

Long-acting reversible contraception, such as the intrauterine device or implant, last for several years. They are about as effective at preventing pregnancy as sterilization. They can be removed at any time if you want to become pregnant.

 

How is the Recovery from the surgery?

 

After surgery, patients stay in a recovery room and are observed for any possible complications. Patients are discharged same day after they receive instructions for home recovery. Patients are asked to see . for a follow-up appointment within.10 days

 

When to contact your doctor?

 

Contact immediately if you experience any of the following:

 
  • Persistent nausea and vomiting for more than 24 hours.
  • Temperature over 100 degrees Fahrenheit for more than 24 hours
  • Redness, swelling, drainage or bleeding around the incision
  • After the first day of surgery: Heavy bleeding with clots or soaking a sanitary pad within 2 hours

Am I ready for sterilization?

 
  • A woman should carefully weigh her decision to undergo sterilization by laparoscopy. Though this procedure has been successfully reversed in some women, in almost all cases it causes a permanent loss of fertility.
  • Women who are unsure if they still want children should choose a less permanent form of contraception, such as birth control pills, an intrauterine device (IUD), or a barrier method (such as a diaphragm). Discuss these alternatives with your .doctor
  • Your partner may also consider having a vasectomy, a method of male sterilization that involves severing and tying the vas deferens, a tube that transports sperm.

Any relation to Vaginal bleeding and menstruation?

 

Vaginal spottingup to .few days after surgery is normal. Many women do not have their next normal menstrual cycle for few weeks after surgery.

 

When to resume Sexual activity?

 

You can resume sexual activity one week after surgery.

 

What is tubal recanalisation?

 

"Tubal Reversal," also called "Tubal Sterilization Reversal," or "Tubal Ligation Reversal," or "Micro surgical Tubal Reaganomics," is a surgical procedure that can restore fertility to women after a tubal ligation. By rejoining the separated segments of the fallopian tube, tubal reversal can give women the chance to become pregnant again.

 

WHAT ARE THE CHANCES OF PREGNANCY AFTER REVERSAL?

 

Approximately 2 out of every 3 patients will become pregnant after tubal ligation reversal

 

Why only laparoscopic procedure for sterilization reversal?

 
  1. Feasibility of laparoscopic tubal sterilization reversal is confirmed, as well as the benefits offered by laparoscopic procedures in terms of quality of life.
  2. Evolution of techniques, skill competency and constant material improvements have allowed this type of surgical procedure to be performed by laparoscopy.
  3. Laparoscopic Tubal Reversal is a minimally-invasive surgical procedure (laparoscopy), using small, specially-designed instruments to repair and reconnect the fallopian tubes.
  4. General anesthesia has been Patients are sent home the same day of surgery. The few stitches that are placed will be under the skin and will be absorbed by the body, without need for removal.
  5. When performed by a trained laparoscopic tubal reversal surgeon, laparoscopic tubal reversal combines the success rates of micro-surgical techniques with the advantages of minimally-invasive surgery - namely faster recovery, better healing, less pain, fewer complications, and no large disfiguring scars.Laparoscopic surgery can be more expensive than an open surgery using a 2 to 3 inch incision because it requires additional surgical equipment.

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

Fax: +91 8023116750

Email: altiushospital@yahoo.com | endoram2006@yahoo.in 

 

Follow the links:

 

Gynecologist in Bangalore | IVF Treatment Center in Bangalore | Uterus Removal Surgery in Bangalore

Laparoscopic Cervical Encerclage

November 25, 2019 by AltiusHospital  

  • Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester.
  • Cervical incompetence occurs in 0.5% to 1% of all pregnancies and has a recurrence risk of 30%. Patients typically present with cervical dilatation in the absence of uterine activity after first trimester usually.
  • Cervical cerclage can be placed via trans vaginal, open -trans abdominal, or laparoscopic trans abdominal approach, preferably before pregnancy.

A laparoscopic approach is superior to the trans abdominal approach in terms of surgical outcomes, cost, and postoperative morbidity.

 

A laparoscopic approach to cervical cerclage placement is a potentially effective adjunct to the treatment of women at high risk of recurrent preterm birth.

 
  1. Laparoscopic and trans abdominal approaches both yield similar obstetric outcomes, and laparoscopic cerclage may be a superior method in terms of surgical outcomes, as suggested by several studies.
  2. Laparoscopic surgical techniques have now increasingly replaced traditional abdominal approaches to gynecologic surgery.
  3. Laparoscopic cervical cerclage is a minimally invasive, extremely safe , cosmetically better pain and bleeding is lesser, intra abdominal adhesion are less, patient feels better postoperative effective procedure in properly selected patients and should replace the traditional laparotomy technique.

 

 

When To Time Procedure?

 

LAPAROSCOPIC cerclage placement can be performed prior to conception or in early pregnancy. Preconception placement provides optimum exposure and reduces risks of excessive bleeding and injury to the pregnancy.

 

Is It better than a vaginal Approach?

 

DEFINITELY. Time and again laparoscopy is the best method in treatment of various disease states in this modern medicine.

 

When the stitch has to be removed?

 

The cerclage remains inside till delivery. It is released during the caesarean section in the operation theater.

 

What Are The Risks Of Having A Cerclage Placed?

 

The likelihood of risks occurring is very minimal, and most health professionals feel a cerclage is a life-saving procedure that outweighs the possible risks involved.

 

What anesthesia is given?

 

its general anesthesia preferably.

 

What will be the recovery period?

 

Generally 2-3 days as with all the Laparoscopy procedures depending on your ability to recover.

 

Who are the candidates for laparoscopic cerclage?

 
  • Previous failed vaginal cerclage with scarring or lacerations rendering vaginal cerclage technically very difficult or impossible.
  • Absent or very hypo-plastic cervix with history of pregnancy loss fitting classical description of cervical insufficiency.

 

Which trimester it has to be planned?

 

The procedure is planned at the end of the first trimester or the early second trimester, after fetal viability has been documented and initial ultrasound evaluation of the pregnancy and preliminary blood tests have ruled out any major congenital malformation.

 

When not to have a cerclage?

 
  • Active labor.
  • Active vaginal bleeding.
  • Abruptio placenta.
  • Premature rupture of membranes.
  • Chorioamnionitis.
  • Prolapsed membranes.
  • Vaginal spotting.

 

What about postoperative care?

 

Elective cerclage is typically an ambulatory procedure. The patient is discharged after recovery from the anesthetic and when she is able to ambulate and void.

 

how to follow up?

 

Frequent visits as informed by your doctor report immediately in case of pain or spotting or bleeding or leaking.

 

What is the success rate?

 

Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 85% to 90% of cases. Cervical cerclage appears to be effective when true cervical incompetence exists

 

Why Doesn't Every Woman Who Has Had A Preterm Baby Need A Cerclage?

 

Only women with an abnormal or "incompetent" cervix can be helped by a cerclage. However, even with the help of a cerclage, other problems can cause labor to begin too early.

 

What About Future Pregnancies?

 

Most women who need a cerclage in one pregnancy will need to have a cerclage placed in future pregnancies.

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

 

Fax: +91 8023116750

 

Email: altiushospital@yahoo.com | endoram2006@yahoo.in 

 

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Laprascopic Tubal Ligation Treatment

November 25, 2019 by AltiusHospital  

  1. Sterilization is any of a number of medical techniques that intentionally leave a person unable to reproduce.
  2. It is a method of birth control.. Sterilization methods include both surgical and non-surgical, and exist for both males and females.
  3. Sterilization procedures are intended to be permanent.

What is sterilization by laparoscopy?

 

Sterilization by laparoscopy is a common procedure used to perform tubal ligation in women. Tubal ligation is a method of sterilization that involves obstruction of the Fallopian tubes. Laparoscopy enables the surgeon to complete tubal ligation by making a small incision near the navel. This smaller incision reduces recovery time after surgery and the risk of complications. In most cases, the woman can leave the hospital within hours after laparoscopy.

 

 

WHEN TO CHOOSE STERILIZATION?

 

A woman should carefully weigh her decision to undergo sterilization .Though this procedure has been successfully reversed in some women, in almost all cases it causes a permanent loss of fertility.

 

Women who are unsure if they still want children should choose a less permanent form of contraception, such as birth control pills, an intrauterine device (IUD), or a barrier method (such as a diaphragm). Discuss these alternatives with your physician.

 

Your partner may also consider having a vasectomy, a method of male sterilization that involves severing and tying the vase deferens, a tube that transports sperm.

 

LAPAROSCOPIC STERILIZATION

 

sterilization by laparoscopy provides a safe and convenient form of contraception. Once completed, no further steps are needed to prevent pregnancy. Tubal ligation also does not change a woman's menstrual cycle or cause menopause.

 

UNDER general anesthesia ,A small incision is then made near the navel. A laparoscope, a thin viewing tube about the width of a pencil, is passed through this incision and the abdomen is inflated to make the organs easier to view.

 

A special device for grasping the Fallopian tubes is inserted through a second, small incision The Fallopian tubes are sealed with a band or clip that is placed over the tubes.

 

After surgery, patients stay in a recovery room and are observed for any possible complications. Patients are discharged generally same day, after they receive instructions for home recovery. Patients are asked for a follow-up appointment within-10 days.

 

Recovery-Bandage can be removed the morning after the surgery. Steri-strips, which resemble tape, can be removed 2 to 3 days after surgery.

 

Patients can return to normal work 1 day after surgery.

 
  • Vaginal bleeding and menstruation

Vaginal bleeding/spotting up to 2-3 weeks after surgery is normal. Many women do not have their next normal menstrual cycle for 4 to 6 weeks after surgery. When your normal cycle returns, you may notice heavier bleeding and more discomfort than usual for the first two to three cycles.

 
  • Sexual activity

You can resume sexual activity 3 week after surgery.

 

Is tubal sterilization reversal?

 

Reversal of the procedure is done in our center by laparoscopic tubal recanalisation.

 

Laparoscopic technique .- of tubal reacanalization minimizes injury to delicate tissue in and around fallopian tubes and helps to ensure clear passage within the tubes for the sperm and the ovum.

 

This improved surgical technique has resulted in live births in 70-80% . The overall success in terms of intrauterine pregnancy after reversal of sterilization by microsurgery is about 60-80%

 

Laparoscopic technique for reversal of sterilization can provide better results than conventional surgery.

 

Although micro surgical reversal achieved 100% potency rate in our patients, certain factors, like duration of sterilization, technique of sterilization, and the length of the tube remaining after reversal, played a crucial role in deciding the pregnancy rate. Besides the magnification and atraumatic technique, tubal length > 4cm and time interval between sterilization and reversal of < 5 years resulted in better pregnancy rate.

 

Although the micro surgical technique has its own limitations, its proper application has brought a ray of hope to women seeking sterilization reversal like wishing to be pregnant after death of a child,or women opting for childbirth from second marriage.

 

What to be considered for women with failed tubal re canalization?

 

Women with severe Fallopian tube disease who are not good candidates for tubal re canalization may consider IVF and embryo transfer as an alternative

 

Am I too old to undergo a tubal reversal?

 
  • it is important to understand that age is an important factor in predicting success following a tubal reversal procedure. Highest success is achieved when a tubal reversal is performed in women who are under the age of 40.
  • However, many women over the age of 40 have excellent ovarian reserve (strong functioning ovaries) and can be quite successful in achieving pregnancy following a tubal reversal.
  • Various tests can be performed to determine a woman's ovarian reserve prior to undergoing a tubal reversal. If it is determined that a woman's ovarian reserve is reduced, alternatives to tubal reversal, such as in vitro fertilization (IVF) can be offered.

For More data Contact Us:

 

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Fax: +91 8023116750

 

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Laparoscopic Sling Procedures

November 4, 2019 by AltiusHospital  

The uterus, or womb, is a muscular structure that's held in place by pelvic muscles and ligaments.

 

 

 

https://www.altiushospital.com/Laparoscopic-Sling-Procedures-Treatment.html

 

If these muscles or ligaments stretch or become weak, they're no longer able to support the uterus, causing prolapse.

 

Uterine prolapse occurs when the uterus sags or slips from its normal position and into the vagina, or birth canal.

 

Uterine prolapse may be incomplete or complete. An incomplete prolapse occurs when the uterus is only partly sagging into the vagina. A complete prolapse describes a situation in which the uterus falls so far down that some tissue rests outside of the vagina.

 

 

https://www.altiushospital.com/Laparoscopic-Sling-Procedures-Treatment.html

https://www.altiushospital.com/Laparoscopic-Sling-Procedures-Treatment.html 

 

What is vaginal vault?

 

The vaginal vault is the expanded region of the vaginal canal at the internal end of the vagina. The vaginal vault may prolapse after a hysterectomy, as there is no uterus supporting the interior end of the vagina. The incidence of vaginal vault prolapse is approximately 15% after hysterectomy due to uterine prolapse, and approximately 1% after hysterectomy due to other reasons.

 

What is sacrocolpopexy?

 

Sacrocolpopexy is a procedure to correct prolapse of the vaginal vault (top of the vagina) in women who have had a previous hysterectomy. The operation is designed to restore the vagina to its normal position and function.

 

How is it done?

 

Sacrocolpopexy Reconstruction is achieved with an open abdominal technique or with the use of minimally invasive techniques means laparoscopy.

 

The specific treatment approach is chosen in accordance with the type and degree of pelvic organ prolapse, as well as the severity of symptoms.

 

The key aspect of sacrocolpopexy is the suspension of the vaginal apex to the sacral promontory in a manner that recreates the natural anatomic support .

 

What happens during surgery?

 

Sacrocolpopexy is performed either through an abdominal incision or 'keyholes' under general anesthesia.

 

The vagina is first freed from the bladder at the front and the rectum at the back.

 

A graft made of permanent synthetic mesh is used to cover the front and the back surfaces of the vagina. The mesh is then attached to the sacrum (tail bone). The mesh is then covered by a layer of tissue called the peritoneum that lines the abdominal cavity; this prevents the bowel from getting stuck to the mesh. Sacrocolpopexy can be performed at the same time as surgery for incontinence or vaginal repair for bladder or bowel prolapse.

 

What are the types of prolapse ?

 

  1. Anterior defects with herniation of the urinary bladder creates a cystocele.
  2. A rectocele occurs from posterior vaginal wall defects-rectum prolapses.
  3. Apical defects include uterine prolapse or uterovaginal prolapse, vaginal cuff prolapse after hysterectomy, and enteroceles.
  4. An enterocele is protrusion of the intestines into the apical vaginal wall and can be in either the anterior or posterior compartment.
  5. All these types can occur with or without uterine prolapse or can be seen post hysterectomy.

 

What are Risk factors for pelvic organ prolapse ?

 

  • Increasing age.
  • Increasing body mass index (obesity).
  • Increasing gravidity/ number of pregnancy.
  • Increasing parity.
  • Number of vaginal deliveries.
  • Macrosomic delivery/bigbaby delivery.
  • Chronic obstructive pulmonary disease.
  • Constipation.
  • Strenuous activity, weight bearing, or strenuous labor.

 

What are the Symptoms ?

 

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  • Vaginal bulge.
  • Pelvic pressure.
  • Bleeding.
  • Infection.
  • Splinting or digitation (the need to manually assist in reducing prolapse, often to void or defecate).
  • Back pain.

 

What are the Concomitant symptoms ?

 

  • Urinary incontinence symptoms, such as stress, urgency, or postural incontinence.
  • Bladder storage symptoms, such as frequency, urgency, or overactive bladder syndrome.
  • Voiding symptoms, such as hesitancy, slow stream, straining, incomplete emptying, or position-dependent voiding.
  • Sexual dysfunction symptoms, such as dyspareunia(pain during sex) or obstructed intercourse.
  • Anorectal dysfunction, such as fecal incontinence, flatal incontinence, fecal urgency, straining to defecate, constipation, and incomplete evacuation.

 

What is the principle used?

 

The key aspect of sacral colpopexy is the use of a graft to support the vaginal wall and suspend the vault to the sacral promontory ( tail bone) to give the anatomic support.

 

Does the surgery need anaesthesia?

 

Laparoscopic technique is done under general anaesthesia after thorough examination and keeping in mind all comorbidities if any.

 

Any advantages of laparoscopy?

 

laparoscopic approach has less blood loss, less hospital stay, almost similar operative time. Less handling of tissues and no adhesions thus minimizing post surgery pain, better cosmetic results, less morbidity, and shorter postoperative recovery periods.

 

What are the after surgery care tips?

 

After surgery -patient can be discharged very next day provided :

 

  1. her recovery is good .
  2. tolerating orally .
  3. well ambulating.
  4. can resume normal activity in days.
  5. Any strenuous activity or heavy lifting should be avoided in the immediate postoperative period, usually 6-8 weeks, to allow adequate time for scar tissue formation.
  6. Activities that generate perineal strain or trauma, such as bicycle riding, should be prohibited.
  7. The patient must refrain from any sexual intercourse during healing.
  8. Additionally, the patient should be instructed to not insert tampons or applicators into the vagina.
  9. A course of antibiotics is often prescribed at discharge.
  10. For postmenopausal patients with significant vaginal atrophy, short-term course of vaginal estrogen therapy is recommended (unless contraindicated) in order to maintain the integrity of pelvic tissues and to maximize surgical success.

 

What are the Nonsurgical treatments ?

 

For mild variety of descent-

 

  • losing weight to take stress off of pelvic structures.
  • avoiding heavy lifting.
  • doing Kegel exercises, which are pelvic floor exercises that help strengthen the vaginal muscles.
  • taking estrogen replacement therapy.
  • wearing a pessary, which is a device inserted into the vagina that fits under the cervix and helps push up and stabilize the uterus and cervix.

 

what about sexual life after surgery?

 

Sexual activity/sexual urge will not be hampered with the surgery with added benefits of correction for incontinence and mass protruding from vagina.

 

Will I feel weak after surgery?

 

surgery will not hamper your physical strength or makes you weak with joint pain as thought always and does not deteriorate daily activity .

 

Laparoscopic sacrocolpopexy is safe cost effective and cosmetic and patient can really consider this option after weighing risks and benefits.

 

What is LAPAROSCOPIC SACRO CERVICOPEXY ?

 

  1. Sacrocervicopexy is a procedure similar to sacrocolpopexy,done for uterine prolapse ie., when the uterus is still intact , in which a graft material is used to suspend the cervix to the ligament on the pelvic bone(anterior longitudinal ligament Os sacrum).
  2. Sacrocervicopexy can be performed either with uterine preservation or after supracervical hysterectomy.
  3. Moreover, it preserves the integrity of ligaments, which are the main supports of the vaginal apex.
  4. Laparoscopic sacrocervicopexy is an effective option for women with pelvic organ prolapse who desire uterine preservation.

 

What will be the time period to go back to work ?

 

2-3 Days

 

Dietary restrictions if any?

 

To have a balanced diet.

 

Any form of exercises to be followed postop ?

 

Any form of physical activity say yoga,meditation,walking ,sport to keep urself fit n fine.

 

will there be weight gain later?

 

Well, Not Exactly. Surgery does not make you put on weight.might be the restriction of physical inactivity self imposed can lead to weight gain.

 

will there be low back ache after surgery ?

 

No, not because of surgery. it could be due to loss of bone mineral density which can be tackled with supplementary medicines and physical activity.

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

 

Fax: +91 8023116750

 

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Pelvic Organ Prolapse Treatment

October 23, 2019 by AltiusHospital  

What is IVF?

 

In vitro fertilisation (IVF) literally means ‘fertilisation in glass’ giving us the familiar term ‘test tube baby’. During the IVF process, eggs are removed from the ovaries and fertilised with sperm in the laboratory. The fertilised egg (embryo) is later placed in the woman’s womb.

 

Is IVF for me?

 

A clinic may recommend IVF as your best treatment option if:

  1. You have been diagnosed with unexplained infertility
  2. Your fallopian tubes are blocked
  3. You have been unsuccessful with other techniques like using fertility drugs or intrauterine insemination (IUI)
  4. There is a minor degree of male subfertility - more severe problems are treated with intra-cytoplasmic sperm injection (ICSI).

 

How does IVF work?

 

IVF techniques can differ from clinic to clinic, often depending on your individual circumstances.

 

A typical treatment may involve:

 

For Women:

 

https://www.altiushospital.com/infertility-treatments.html

  

Step 1: Suppressing the natural monthly hormone cycle

 

As a first step you may be given a drug to suppress your natural cycle. Treatment is given as a daily injection. This continues for about two weeks.

 

Step 2: Boosting the egg supply

 

After the natural cycle is suppressed you are given a fertility hormone called FSH (or Follicle Stimulating Hormone). This is usually taken as a daily injection for around 12 days. This hormone will increase the number of eggs you produce - meaning that more eggs can be fertilised. With more fertilised eggs, the clinic has a greater choice of embryos to use in your treatment.

 

Step 3: Checking on progress

 

Throughout the drug treatment, the clinic will monitor your progress. This is done by vaginal ultrasound scans and, possibly, blood tests. 34–38 hours before your eggs are due to be collected you have a hormone injection to help your eggs mature.

 

Step 4: Collecting the eggs

 

Eggs are usually collected by ultrasound guidance under sedation. This involves a needle being inserted into the scanning probe and into each ovary. The eggs are, in turn, collected through the needle. Cramping and a small amount of vaginal bleeding can occur after the procedure.

 

Step 5: Fertilising the eggs

 

Your eggs are mixed with your partner’s or the donor’s sperm and cultured in the laboratory for 16–20 hours. They are then checked to see if any have fertilised. Those that have been fertilised (now called embryos) are grown in the laboratory incubator for another one to two days before being checked again. The best one or two embryos will then be chosen for transfer. After egg collection, you are given medication to help prepare the lining of the womb for embryo transfer. This is given as pessaries, injection or gel.

 

Step 6: Embryo transfer

 

For women under the age of 40, one or two embryos can be transferred. If you are 40, or over, a maximum of three can be used. The number of embryos is restricted because of the risks associated with multiple births. Remaining embryos may be frozen for future IVF attempts, if they are suitable.

 

Step 7: Other treatments

 

Some clinics may also offer blastocyst transfer, where the fertilised eggs are left to mature for five to six days and then transferred.

 

Step 8: Collecting sperm

 

Around the time your partner’s eggs are collected, you are asked to produce a fresh sample of sperm. This is stored for a short time before the sperm are washed and spun at a high speed. This is so the healthiest and most active sperm can be selected.

 

Intra-cytoplasmic sperm injection (ICSI)

 

What is intra-cytoplasmic sperm injection and how does it work?

 

Intra-cytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into an egg in order to fertilise it. It is a process sometimes used during in vitro fertilisation treatment (see IVF patient information leaflet).The fertilised egg (embryo) is then transferred to the woman’s womb.

 

ICSI is often recommended if:

  • The male partner has a very low sperm count.
  • Other problems with the sperm have been identified, such as poor morphology (abnormally shaped) and/or poor motility (poor swimmers).
  • At previous attempts at in vitro fertilisation (IVF) there was either failure of fertilisation or an unexpectedly low fertilisation rate.
  • The male partner has had a vasectomy and sperm have been collected from the testicles or epididymis (sperm reservoir).
  • Other situations where the sperm count is zero and donor insemination is not wanted.
  • The male partner does not ejaculate any sperm but sperm have been collected from the testicles.
  • The male partner has had problems obtaining an erection and ejaculating. This includes men with spinal cord injuries, diabetes and other disorders.

 

How does ICSI work?

 

The procedure for ICSI is similar to that for IVF, but instead of fertilisation taking place in a dish, the embryologist selects sperm from the sample and a single sperm is injected directly into each egg. After two to three days in the laboratory, those that are fertilised are transferred to your womb in the same way as for conventional IVF.

 

The major development of ICSI means that as long as some sperm can be obtained (even in very low numbers), fertilisation is possible.

 

For More data Contact Us:

 

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Cervical Encerclage Treatment in Bangalore

October 9, 2019 by AltiusHospital  

What is cervical cerclage?

 

Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth.

 

https://www.altiushospital.com/

 

When is it done?

 

Usually the treatment is done in the second trimester (12-14 weeks) of pregnancy, for a woman who had either one or more late miscarriages in the past. It can be planned prior to pregnancy when it is done abdominally and laparoscopically.

 

Who needs a cervical circlage?

 

A doctor might recommend a cerclage be performed if a woman has one or more of the following risk factors:

  • a previous preterm delivery
  • previous trauma or surgery to the cervix
  • H/O early rupture of membranes ("breaking water")
  • hormonal influences
  • abnormalities of the uterus or cervix

 

In women with a prior spontaneous preterm birth and who are pregnant with one baby, and have shortening of the cervical length less than 25 mm, a cerclage prevents a preterm birth and reduces death and illness in the baby.

 

What are various methods of it?

 

Types: There are three types of cerclage

 

Mc Donald’s circlage is essentially a pursestring stitch used to cinch the cervix shut; the cervix stitching involves a band of suture at the upper part of the cervix while the lower part has already started to efface. This cerclage is usually placed between 16 weeks and 18 weeks of pregnancy. The stitch is generally removed around the 37th week of gestation

 

A Shirodkar cerclage is very similar, but the sutures pass through the walls of the cervix so they're not exposed. The Shirodkar procedure sometimes involves a permanent stitch around the cervix which will not be removed and therefore a Caesarean section will be necessary to delivera an abdominal cerclage, the least common type, is permanent and involves placing a band at the very top and outside of the cervix, inside the abdomen. This is usually only done if the cervix is too short to attempt a standard cerclage, or if a vaginal cerclage has failed or is not possible. A c-section is required for women giving birth with a TAC. A transabdominal cerclage can also be placed pre-pregnancy if a patient has been diagnosed with an incompetent cervix.

 

What are the preparations made before cerclage?

 

Before the procedure may be performed, there are a number of preparatory steps that must be taken. A complete medical history will be taken. A cervical exam will be necessary to assess the state of the cervix; usually a transvaginal (through the vagina) ultrasound will be performed. No food or drink will be allowed after midnight before the day of surgery to avoid nausea and vomiting during and after the procedure. The patient will also be instructed to avoid sexual intercourse, tampons, and douches for 24 hours before the procedure. Before the procedure is performed, an intravenous (IV) catheter will be placed in order to administrate fluids and medications.

 

Lap circlage- how is it done?

 

The procedure is performed under anesthesia through a laparoscopic ports. The peritoneum overlying the bladder and uterus is divided, and the bladder is pushed caudally. The uterine vessels are identified and displaced laterally, and a suture is then placed around the cervix at the levelof the internal os. The suture is tied posteriorly; this is to allow removal of the suture by posterior colpotomy if necessary. Some surgeons tie the suture anteriorly. The uterine vessels have to be dissected from the cervix to allow insertion of the suture medially. The technique is more demanding than that by the vaginal approach, and might lead to excessive bleeding from the uterine vessels. Transillumination of the uterine vessels and their branches with a laparoscope, and placing the suture through the avascular area of the paracervical tissue medial to the vessels, have been proposed. Most cases of abdominal cerclage have been performed during pregnancy, usually after 10 weeks of gestation. Abdominal cerclage by laparotomy and by laparoscopy have been performed in the pregnant and non-pregnant states. Compaired to open method Lap has faster recovery.

 

What is aftercare for circlage?

 

After Care INSTRUCTIONS:

 

Medicines:

  • Take your medicine as directed: 
  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider.
    Pain medicine: You may need medicine to decrease pain. 
  • Constipation: Do not try to push the bowel movement out if it is too hard. High-fiber foods, extra liquids, and regular exercise can help you prevent constipation. Examples of high-fiber foods are fruit and bran. Regular exercise helps your digestive system work. You may also be told to take over-the-counter fiber and stool softener medicines. Take these items as directed. 
  • Rest: You may need to rest in bed while lying on your left side most of the time. Avoid heavy work to prevent premature labor or delivery. 
  • Vaginal or wound care: When you are allowed to bathe or shower, carefully wash without wetting abdominal cuts. Afterwards, put on clean sanitary pad. Change your bandages or pad any time it gets wet or dirty. Avoid placing anything inside your vagina, such as a douche or tampon. Ask your caregivers for more information about vaginal and wound care.

 

CONTACT A CAREGIVER IF:

  • You have a fever.
  • You have chills, a cough, or feel weak and achy.
  • You have nausea (upset stomach) or vomiting (throwing up).
  • Your bandage becomes soaked with blood.
  • Your skin is itchy, swollen, or has a rash.
  • You have questions or concerns about your surgery, condition, or care.

 

SEEK CARE IMMEDIATELY IF:

  • You feel something is bulging out into your vagina.
  • You have clear fluid coming from your vagina.
  • You have lower abdominal or back pain that comes and goes like labour pains.
  • You have pus or a foul-smelling odour coming from your vagina.
  • You have regular contractions.
  • You have trouble passing urine.
  • You have vaginal bleeding.

 

What are the results of circlage?

 

The success rate for cervical cerclage is approximately 80-90% for elective cerclages, and 40-60% for emergency cerclages. A cerclage is considered successful if labor and delivery is delayed to at least 37 weeks.

 

What is Rescue cerclage?

 

In cases with advanced cervical dilatation and bulging membranes, it has been referred to as (heroic cerclage) or rescue cerclage due to its poor success rate Cervical cerclage in advanced cervical dilatation with bulging membranes in the second trimester is controversial. The outcome of these pregnancies is usually poor, but without a cerclage the loss of pregnancy is inevitable. The outcome can be improved if initially a uterine contraction suppressant is used and vaginal infection can be treated. These patients need a lot of counseling and be made aware of the risk of losing the pregnancy. Prolonging pregnancy to reach just viable gestations may also increase overall morbidity. It has been suggested that infection is likely to play a part in many cases of miscarriage in the second trimester and therefore screening for infection before insertion of the suture may predict prognosis. However, in women with bulging membranes, delay in the insertion of the suture is likely to increase the risk of infection, due to the increased exposure of the fetal membranes to vaginal bacteria Reported survival rates following emergency cerclage vary from 12.5% to 63% in women with cervical dilatation of >3cm.

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

 

Fax: +91 8023116750

 

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Vaginoplasty in Bangalore

September 25, 2019 by AltiusHospital  

Altius Hospital is one of the India’s best leading centres with Gynaec Laparoscopic surgery, Infertility & Urogynaecology treatments. It is a 50 Bedded Hospital with High Tech State of the art speciality centre. Our Hospital is renowned as the Third Operation Theatre in the country and to have OR1 system first in Karnataka.

 

Vaginal Discharge

 

 

 

https://www.altiushospital.com/Vaginal-Discharge-Treatment.html

 

Vaginal discharge is most often a normal and regular occurrence. However, there are certain types of discharge that can indicate an infection. Abnormal discharge may be yellow or green, chunky in consistency, or have a foul odor.

 

Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection.

 

What is Normal?

 

https://www.altiushospital.com/Vaginal-Discharge-Treatment.html

 

Women develop PID when certain bacteria, such as chlamydia or gonorrhea, move upward from a woman's vagina or cervix into her reproductive organs. PID is a serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea.

 

Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky whitish), depending on the time in your menstrual cycle.

 

For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene.

 

When is It Abnormal

 

https://www.altiushospital.com/Vaginal-Discharge-Treatment.html

 

if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition.

 

What should I do if I have abnormal vaginal discharge?

 

https://www.altiushospital.com/Vaginal-Discharge-Treatment.html

 

Vaginal discharge is perfectly normal but if your discharge looks unusual and you experience other symptoms such as itching and swelling of the vagina, fever, fatigue, pain in the abdomen, unexplained weight loss, or increased urination, you should consult your doctor.

 

What does a lot of vaginal discharge mean?

 

  • In the majority of cases, excessive vaginal discharge is merely the body's reaction to certain physiological changes.
  • The amount of discharge varies during your menstrual cycle.
  • It's normal for vaginal discharge to increase with ovulation, breastfeeding, exercise, sexual arousal, the use birth control pills and emotional stress.
  • A lot of discharge is often observed in early pregnancy. Although in most cases excessive discharge is normal, sometimes it can indicate serious problems such as a vaginal infection or a cervical or vaginal tumor.

https://www.altiushospital.com/Vaginal-Discharge-Treatment.html

 

Some of the surgeries performed here are:

 

  1. Vaginal hysterectomy for non-descent upto 24 weeks size
  2. Vaginal hysterectomy for uterine prolapse, cystocele, enterocele, rectocele
  3. Vaginal repair of vault prolapse
  4. Vaginal sacrospinous colpopexy
  5. Fistula repairs
  6. Pelvic floor repair with mesh- APOGEE/PERIGEE, ANTERIOR PROLIFT, POSTERIOR    PROLIFT, ELEVATE
  7. Vaginal surgery for stress urinary incontinence (leaking of urine during coughing,    sneezing, etc) using, tapes -TVT, TOT, TVT-O, MINISLING, OPHIRA etc
  8. Vaginoplasty
  9. Hymenectomy
  10. Sex reversal surgery

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

 

Fax: +91 8023116750

 

Email: altiushospital@yahoo.com | endoram2006@yahoo.in

 

Follow the links:

 

Gynecologist in Bangalore | IVF Treatment Center in Bangalore | Endometriosis Treatment in Bangalore | Scarless Surgery in Bangalore | Urogynaecology Treatments in Bangalore

Laproscopic Ovarian Drilling Treatment in Bangalore

September 23, 2019 by AltiusHospital  

If you have been diagnosed with polycystic ovary syndrome (PCOS),you are probably no stranger to fertility problems. You may have tried to lose weight or take different fertility drugs to help you conceive. But if these PCOS fertility treatments did not work for you, you may wonder if there is another option. Ovarian drilling could be your answer.

 

Ovarian drilling for PCOS treatment:

 

https://www.altiushospital.com/laparoscopic-procedures.html

 

Polycystic ovary syndrome can cause your body to produce too much testosterone and insulin, leading to fertility problems. High testosterone levels can cause irregular menstrual cycles, prevent ovulation and hinder pregnancy. PCOS treatments, including ovarian drilling, could help you conceive by regulating your hormone levels and improving your ovulation and menstrual cycles. Laproscopic ovarian drilling may also increase ovarian blood flow, allowing a high delivery of gonadotrophins and post-surgical local growth factors. There is also an improvement of insulin sensitivity after ovarian drilling which helps in ovulation.

 

Laparoscopic ovarian drilling may improve the effectiveness of other ovulation induction treatments. The oral drug, clomiphene citrate , is the first-line treatment for PCOS, yet, one fifth of women are resistant to the drug and fail to ovulate. In such cases, laproscopic ovarian dirlling may prove to be an effective alternative.

 

How does ovarian drilling work?

 

It may sound scary, but “ovarian drilling” is relatively simple and minimally invasive. Ovarian drilling is a laparoscopic procedure performed under general anesthesia. The surgery is typically done on an outpatient basis with minimal recovery time. Here is how ovarian drilling works:

  1. Your surgeon makes a small incision below your belly button. Because the incisions are so small, laparoscopy is often called "Band-Aid surgery."
  2. He or she inserts a tube into your abdomen, filling itwith carbon dioxide. This inflates your abdomen and prevents damage to your internal organs.
  3. A thin telescope with a camera attached is inserted into your abdomen, allowing your surgeon to view your internal organs and ovaries. Guided by the camera, the surgeon inserts special tools and uses an electric current to make very small holes on your ovaries. The common technique of ovarian drilling is the use of monopolar electrocautery (diathermy) or laser with comparable results. Normally, three to eight diathermy punctures are performed in each ovary using 40 watts energy for each puncture.

 

Will ovarian drilling work for me?

 

If your periods become regular after ovarian drilling, your chances of pregnancy are good. About half of all women that go through with ovarian drilling become pregnant within one year. Even if your cycles do not become more regular after ovarian drilling, you may have better success in getting pregnant with the help of fertility drugs.

 

Advantages of Laproscopic

 

https://www.altiushospital.com/

  

Ovarian Drilling:

 

Ovarian drilling has lower rates of ovarian hyperstimulation syndrome and of multi-fetal gestation. The advantages of the procedure also include its singular treatment, as opposed to several trials of ovulation inductions. Other benefits of this technique include cost-effectiveness and that it can be performed as an outpatient procedure.

 

Talk with your doctor to determine if you are a good candidate for ovarian drilling. By regulating your cycles for several months or more, ovarian drilling may offer you a window of opportunity to become pregnant that you did not have before.

 

For More data Contact Us:

 

Telephone: +91 8023151873 | +91 9900031842

 

Fax: +91 8023116750

 

Email: altiushospital@yahoo.com | endoram2006@yahoo.in

 

Follow the links:

 

Gynecologist in Bangalore | IVF Treatment Center in Bangalore | Endometriosis Treatment in Bangalore | Scarless Surgery in Bangalore | Urogynaecology Treatments in Bangalore